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The Archives of Bone and Joint Surgery
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Williams, A., Tischler, E., Sholder, D., Nicholson, T., Maltenfort, M., Getz, C., Williams Jr, G., Namdari, S. (2018). Identification of Risk Factors for Abnormal Postoperative Chemistry Labs after Primary Shoulder Arthroplasty. The Archives of Bone and Joint Surgery, 6(4), 282-288. doi: 10.22038/abjs.2018.26686.1706
Alexis A. Williams; Eric H. Tischler; Daniel Sholder; Thema A. Nicholson; Mitchell G. Maltenfort; Charles Getz; Gerald Williams Jr; Surena Namdari. "Identification of Risk Factors for Abnormal Postoperative Chemistry Labs after Primary Shoulder Arthroplasty". The Archives of Bone and Joint Surgery, 6, 4, 2018, 282-288. doi: 10.22038/abjs.2018.26686.1706
Williams, A., Tischler, E., Sholder, D., Nicholson, T., Maltenfort, M., Getz, C., Williams Jr, G., Namdari, S. (2018). 'Identification of Risk Factors for Abnormal Postoperative Chemistry Labs after Primary Shoulder Arthroplasty', The Archives of Bone and Joint Surgery, 6(4), pp. 282-288. doi: 10.22038/abjs.2018.26686.1706
Williams, A., Tischler, E., Sholder, D., Nicholson, T., Maltenfort, M., Getz, C., Williams Jr, G., Namdari, S. Identification of Risk Factors for Abnormal Postoperative Chemistry Labs after Primary Shoulder Arthroplasty. The Archives of Bone and Joint Surgery, 2018; 6(4): 282-288. doi: 10.22038/abjs.2018.26686.1706

Identification of Risk Factors for Abnormal Postoperative Chemistry Labs after Primary Shoulder Arthroplasty

Article 6, Volume 6, Issue 4, July 2018, Page 282-288  XML PDF (362 K)
Document Type: RESEARCH PAPER
DOI: 10.22038/abjs.2018.26686.1706
Authors
Alexis A. Williams1; Eric H. Tischler2; Daniel Sholder2; Thema A. Nicholson2; Mitchell G. Maltenfort2; Charles Getz2; Gerald Williams Jr2; Surena Namdari orcid 2
1Sidney Kimmel Medical College at Thomas Jefferson University, Department of Orthopaedics Surgery, Philadelphia, PA
2The Rothman Institute, Thomas Jefferson University, 925 Chestnut St. 5th Floor, Philadelphia, PA
Abstract
Purpose
Purpose
The purpose of this study was to determine patient-specific risk factors and clinical intervention rates for abnormal postoperative Chem-7 panels in shoulder arthroplasty patients.

Methods
Retrospectively, all primary anatomic total (aTSA) and reverse shoulder (RTSA) arthroplasties (between 2007-2013) performed at a single institution were identified. All patients underwent routine preoperative and postoperative day one (POD1) chemistry panels. Each clinically significant component of the Chem-7 panel was independently evaluated using a multivariate analysis to identify risk factors for abnormal results. Associated clinical intervention rates were also calculated.

Results
Data from 1,012 patients (248 RTSA; 764 aTSA) was analyzed. 5.4% of patients had at least one preoperative abnormal chemistry result. On multivariate analysis, patients with abnormal preoperative Chem-7 labs and a history of renal disease had significantly increased risk for abnormal POD1 labs (p <0.001). Although 25.6% (259/1,012) of patients had at least one abnormal POD1 lab result, the total postoperative clinical intervention rate was 15.1% (39/259).

Conclusion
Renal disease and a preoperative abnormal chemistry result are important risk factors for abnormal postoperative Chem-7. Optimizing renal status and correcting abnormal blood chemistry results preoperatively may reduce the incidence of abnormal postoperative chemistry results.
Keywords
Blood chemistry; Laboratory order; Reverse shoulder arthroplasty; Risk stratification; Total Shoulder Arthroplasty
Main Subjects
Shoulder
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